Introduction: New-onset diabetes after transplantation (NODAT) is a clinically significant complication associated with adverse metabolic and graft outcomes and affects patients’ quality of life. Data in paediatric populations are limited. This case series describes the incidence, clinical characteristics, and early outcomes of NODAT in a paediatric kidney transplant cohort. Cases: Thirty patients (aged 5–17 years; 16 males, 14 females; 14 Malay, 15 Chinese, 1 Indian) underwent renal transplantation at Hospital Tunku Azizah between 2019 and 2025. NODAT was identified using standard diagnostic criteria and occurred in four patients (13.3%). Among patients who developed NODAT, three were Malay and one Chinese; all were aged 10–17 years, with a predominance of females (n = 3). All were non-obese (body mass index [BMI]: 11–21.4 kg/m²), and only one had a family history of type 2 diabetes mellitus. Underlying causes of ESRF in these patients included focal segmental glomerulosclerosis (FSGS, n = 2), CAKUT (n = 1), and unknown etiology (n = 1). Two patients received kidneys from living donors, and two from cadaveric donors. Two patients demonstrated reduced C-peptide levels, consistent with impaired insulin secretion. All patients received steroid induction and maintenance therapy alongside tacrolimus-based immunosuppression, with one patient also receiving everolimus. Two patients developed post-transplant CMV viremia, which has been associated with NODAT. The onset of NODAT was early, occurring within 2 weeks post-transplant in three patients and at 1 month in one patient. Insulin therapy achieved glycemic control in all cases. Two patients were able to discontinue insulin within 3–4 months, suggesting recovery of endogenous glycemic regulation, while the remaining two required ongoing insulin therapy. Conclusion NODAT affects a substantial proportion of paediatric kidney transplant recipients and may present despite the absence of conventional risk factors. Early surveillance is essential. The observed potential for insulin independence may indicate a reversible component of β-cell dysfunction, which warrants further investigation in larger cohorts.
Child ; Kidney Transplantation ; Hospitals

Introduction: Aquilaria malaccensis, also known as “Pokok Karas” in Malaysia, is widely used in Southeast Asian countries for the treatment of joint pain, diarrhoea and inflammatory diseases, and has shown beneficial effects as an anticancer agent. The aim of this study was to investigate the effect of ethanol leaf extracts of A. malaccensis on MCF-7 cells. Methods: MTT-based cytotoxic and antiproliferative assay was used to determine the outcome of ethanolic extract toward MCF-7 cells. The mode of cell death was determined by the AO/PI double staining assay and the depolarisation of the mitochondria membrane potential. Results: IC50 value of the extract against MCF-7 cells treated for 72 hours was 4.1 ± 2.08 µg/mL, while the IC50 value for doxorubicin was 2.92 ± 0.12 µg/mL. The extract showed a lower cytotoxic effect against the NIH/3T3 cells and inhibited the growth of MCF-7 cells in a dose dependent manner. AO/PI double stain showed that the ethanolic extract of A. malaccensis leaves induced MCF-7 cells into apoptotic cell death. The present study showed that the ethanolic extract of A. malaccensis induced apoptosis through mitochondrial pathway as indicated by its ability to take up JC-1. Conclusion: The study found that ethanolic extract obtained from A. malaccensis leaves is cytotoxic on MCF-7 cells, resulting to apoptotic cell death of the cells.

Introduction: Inhibition of the cholinesterase’s function leads to paralysis and death. This mechanism is served as a common mode of action of insecticide. The three tropical seaweeds, namely Bryopsis pennata, Padina australis and Sargassum binderi were reported for its potential mosquito larvicidal effect. In the present study, these seaweeds were evaluated for their potential as a cholinesterase inhibitor in the mechanism of larvicidal action. Methods: Acetylcholinsterase (AChE) inhibition assay was carried out based on the colorimetric method using a microplate reader. Phytochemical content of the seaweed extracts was screened by using liquid chromatography-mass spectroscopy (LC-MS). Results: Green seaweed B. pennata showed the strongest inhibition effect towards in vitro AChE by using tissue homogenates of Aedes aegypti (IC50 value = 0.84 mg mL-1) and Aedes albopictus as the enzyme source (IC50 value = 0.92 mg mL-1). The pattern of Lineweaver-Burk plots revealed that B. pennata was a mixed type inhibitor of AChE, as the readings of Km, Vmax, Ki and Ki’, indicates that it had a strong inhibition ability with high binding affinity towards both free enzyme and enzyme-substrate complex. Conclusion: These findings suggest the compound(s) in B. pennata extract serves as a promising source that could be developed into a mosquito larvicidal agent with AChE inhibition effect.

Dengue is an increasing threat in Malaysia, particularly in the more densely populated regions of the country. We present an Artificial Intelligence driven model in predicting Aedes outbreak, using predictors of weather variables and vector indices sourced from the Ministry of Health. Analysis and predictions to estimate Aedes populations were conducted, with its results being used to infer the possibility of dengue outbreaks at pre-determined localities around the Klang Valley, Malaysia. A Bayesian Network machine learning technique was employed, with the model being trained using predictor variables such as temperature, rainfall, date of onset and notification, and vector indices such as the Ae. albopictus count, Ae. aegypti count and larval count. The interfaces of the system were developed using the C# language for Server-side configuration and programming, and HTML, CSS and JavaScript for the Client Side programming. The model was then used to predict the population of Aedes at periods of 7, 14, and 30 days. Using the Bayesian Network technique utilising the above predictor variables we proposed a finalised model with predictive accuracy ranging from 79%-84%. This model was developed into a Graphical User Interface, which was purposed to assist and educate the general public of regions at risk of developing dengue outbreak. This remains a valuable case-study on the importance of public data in the context of combating a public health risk via the development of models for predicting outbreaks of dengue which will hopefully spur further sharing of data by all parties in combating public health threats.

Objective: To assess the insecticide susceptibility status of Anopheles cracens (An. cracens) and Anopheles maculatus (An. maculatus) from knowlesi malaria endemic areas in Peninsular Malaysia towards DDT, malathion and deltamethrin and to determine the resistance mechanism involved. Methods: Adult and larval mosquitos were collected for surveillance. Susceptibility status of Anopheles was determined using the standard WHO adult bioassay, larval bioassay and biochemical enzyme assay. Results: WHO adult bioassay results indicated An. cracens collected from Kampung Sungai Ular, Pahang was resistant towards 4% DDT, while An. maculatus collected from Kampung Sokor, Kelantan and Kampung Sungai Lui, Selangor exhibited resistance towards 4% DDT. However, the enzyme activity profiles varied according to strains and species. The resistance ratio of larval bioassay, showed that all strains and species tested were susceptible to malathion and temephos. Conclusions: Since only a few anopheline strains exhibited low level of insecticide resistance towards malathion, DDT and temephos. These insecticides are still considered effective for vector control program towards An. cracens and An. maculatus.

Work-related upper-extremity disorders (WRUEDs) are frequently occurring among workers in general. Various researches support the empirical results of the Autogenic factors related to such problems of health and safety. Research shows the association of different aspects of work organization strengthen the possibilities of work-related stress and other psychosocial factors, which may lead towards adverse health conditions. To review the previous work done for finding the association between psychosocial factors and upper extremity disorders. Findings from different studies have been reviewed to examine the psychosocial factors association in developing WRUEDs. Published studies, which were primarily focused on WRUEDs and psychosocial factors association, were reviewed. Various studies have shown the relationship between psychosocial factors and UEDs. Due to the different nature of epidemiology of the disorder and variable differences, findings from different studies contradicts. Finally, this review presents the limitations in existing studies, and further research has been proposed for future.

Objective: To investigate the larvicidal activity, inhibition effect on development, histopathological alteration and morphological aberration induced by the extracts derived from seaweeds Bryopsis pennata (B. pennata). Sargassum binderi (S. binderi) and Padina australis in Aedes aegypti (Ae. aegypti) larvae and to characterize the phytochemical components of the three seaweeds. Methods: Larvicidal activity of the seaweeds towards the larvae of Ae. aegypti was determined according to WHO. The inhibition effect of seaweeds was assessed by determining the mortality, adult emergence rate, larval and pupa duration of the treated larvae. Histopathological effect on midgut epithelium of larvae and morphological aberration induced by the methanol extracts were examined. Phytochemical analysis was done to determine the presence of alkaloids, saponins, steroids and terpenoids in the seaweeds. Results: Chloroform partition of B. pennata extract exhibited the strongest larvicidal activity (LC

The rapid detection of dengue infection in mosquito vectors is important for early warning to forestall an outbreak. Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) provides a rapid method for dengue detection in man and mosquitoes. An RT-PCR kit developed by the Medical Entomology Unit, Institute for Medical Research to detect dengue infection in mosquitoes, was tested for its shelf life at 3 storage temperatures: room temperature, refrigerator and freezer. Test kits were tested once every 3 days for kits stored at room temperature, and once every week for those stored at refrigerator and freezer temperatures. The results showed that the test kit could only be stored above its recommended storage temperature of -20 degrees C for not more than 3 days. DNA 100 bp markers in the kits appeared to be stable at the tested temperatures and were usable up to the 20th day when stored at 2 degrees C and below.
Culicidae ; Dengue ; Reverse Transcriptase Polymerase Chain Reaction ; seconds ; Infection as complication of medical care

Artificial feeding of mosquitoes with blood meal is an important technique in the studies of mosquito feeding. Owing to the difficulty in obtaining suitable artificial membranes for mosquito feeding from other sources, several easily obtainable membranes in Malaysia were tested for their suitability as a replacement. Skin of chicken, fish, and salted sausage were obtained and tested against cattle skin membrane as a control. The results showed that cattle skin is still the most favorable membrane to be used, with full engorgement rate of around 57% using fresh human blood. However, processed chicken skin was shown having potential for further testing since with feeding using human blood kept overnight at 4 degrees C, an engorgement rate of 50% was obtained.
Feeding ; Integumentary system ; Culicidae ; In Blood ; Engorgement